Faculty of Health, Staffordshire University, Brindley Building, Leek Road, Stoke-on-Trent ST4 2DF, United Kingdom.
Gait Posture. 2012 Mar;35(3):383-8. doi: 10.1016/j.gaitpost.2011.10.356. Epub 2011 Nov 21.
Foot orthoses (FO) are commonly used in the treatment of numerous lower limb problems, pains and injuries. Whilst many studies report their positive effects, and most practitioners would confirm those findings, the available information appears to be anecdotal. As such, the exact mechanisms in which FO work are not fully understood. Therefore, a need exists to study the influence of the inter-practitioner variability in the assessment of orthoses performance. This investigation is central to the understanding of the performance variations in custom-made foot orthoses (CFO). Eleven practitioners took part in the study. Each practitioner completed a clinical assessment of one subject, after which a pair of foot orthoses was manufactured based on casts of the subject's feet using a neutral non-weight bearing plaster cast. Ten trials per condition were recorded during which kinematic and kinetic data were collected. CFO did not have any systematic significant effects (p<0.05) on any kinetic except for the right-leg peak active force. In addition, systematic kinematic effects could be observed mainly for the sagittal plane for forefoot-to-hindfoot and hindfoot-to-tibia peak angles. The results from this study demonstrate that inter-practitioner variability is a major factor in orthotic intervention in treating a single patient and for a specific pathology. It is therefore strongly recommended to use caution when drawing general conclusions from research studies using custommade foot orthoses. The results suggest that CFO effects can differ between limbs. More importantly, their effects are also practitioner-dependant. Great caution should be used when comparing studies on CFO with different practitioners as conclusions could vastly differ.
足部矫形器（FO）常用于治疗许多下肢问题、疼痛和损伤。虽然许多研究报告了它们的积极效果，而且大多数从业者也证实了这些发现，但可用的信息似乎只是传闻。因此，FO 发挥作用的确切机制尚未完全了解。因此，需要研究评估矫形器性能的从业者间变异性的影响。这项研究对于理解定制足部矫形器（CFO）的性能变化至关重要。11 名从业者参加了这项研究。每位从业者对一名受试者进行临床评估，然后根据受试者脚部的石膏模型使用中性非负重石膏模型制造一对足部矫形器。在每种情况下记录了 10 次试验，在此期间收集了运动学和动力学数据。除右腿主动力峰值外，CFO 对任何动力学参数均无系统显著影响（p<0.05）。此外，主要在矢状面观察到系统运动学效应，包括前足-后足和后足-胫骨峰值角度。本研究结果表明，从业者间的变异性是治疗单个患者和特定病理的矫形干预的主要因素。因此，当从使用定制足部矫形器的研究中得出一般性结论时，应谨慎行事。结果表明，CFO 的效果可能因肢体而异。更重要的是，其效果也取决于从业者。当比较具有不同从业者的 CFO 研究时，应非常谨慎，因为结论可能大不相同。
